Key clinical point: Most of the unusual benign uptakes in PET/CT scans of prostate cancer patients were associated with inflammatory processes, and also were found in the thyroid, adrenal gland, brain, liver, bowel, frontal sinus, lungs, parotid gland, and bone.

Major finding: Unusual uptakes appeared in 47 of 368 patients (12.8%). Of these, 41 were benign uptake, mostly because of inflammatory processes (22 of 47).

Study details: The data come from a retrospective study of 368 prostate cancer patients who were underwent F-choline PET/CT between January 2012 and March 2019 for initial staging because of suspicious findings or for evaluation of cancer recurrence.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Commentary

“Appropriate imaging is a cornerstone in the evaluation and staging of patients with prostate cancer. F-choline PET/CT has been utilized at some centers for initial staging or restaging at biochemical recurrence. While this technique can be useful, other diseases besides prostate cancer may be detected during staging. In this retrospective cohort study, Roland et al describe a spectrum of etiologies aside from prostate cancer that result in increased Standard Uptake Value (SUV) on PET/CT imaging. Of 368 patients evaluated, 47 (12.8%) had unusual SUV findings on imaging. The most common were attributed to likely inflammatory processes in lymph nodes (22/47), lung cancer (4/47), and other cancers (2/47). As F-choline PET/CT is replaced by other PET/CT imaging techniques, (such as PSMA-PET/CT), close attention will need to be paid to similar findings (some of which have already been described) that may affect prostate cancer disease management.”

Mark Klein, MD